January 10, 2017

ObamaCare was always about paying for health care—costs have outpaced inflation for decades—but seldom about keeping people healthy. As Republicans repeal and replace, they need a vision for the path to better care. Technology now exists to provide cheaper and higher-quality health care, but giant roadblocks stand in the way.

That technology is artificial intelligence and machine learning. The algorithms behind AI are painfully complex, but the final product is simple—think Google Translate or Amazon’s Alexa. Saying a phrase and immediately having it translated is cool. Being told that your week of bad sleep and slight stomach pains could be cancer is life-altering.

Machine learning is already invading health care. Experts at Kaggle, an artificial-intelligence research firm, shared a few real-world applications of the technology with me: Predicting heart failure by looking at massive amounts of MRI scans, diagnosing diabetic retinopathy from eye imaging, and successfully predicting seizures with a machine analyzing electroencephalogram data.

The key is data. With more of it, accuracy gets better over time. At least on the surface, the Obama administration did something right—the Health Information Technology for Economic and Clinical Health, or Hitech, Act. Part of the 2009 stimulus largess, it set aside some $20 billion worth of incentives for hospitals and doctors to show “meaningful use” of electronic health records, or EHRs.

Tons of data come with medical records. Then there are digital scales, Fitbit steps, WellnessFX blood tests, Apple iWatch data and 23andMe genetic test results. Eventually there will be daily commode sensors measuring blood sugar and prostate-specific antigen levels, among other things. Now imagine all that data being crunched, in real time, by machines looking for patterns—which then put out a simple text message. “Your Hemoglobin A1c has spiked again. I thought we agreed to cut back on the linguine.”